Lesson learned from ACCESS (A Case Controlled Etiologic Study of Sarcoidosis)
Milton D Rossman1, Mary Elizabeth Kreider
1Pulmonary, Allergy, and Critical Care Division, Department of Medicine, Hospital of University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. rossmanm@mail.med.upenn.edu
Proceedings of the American Thoracic Society
|August 9, 2007
Summary
The ACCESS study investigated sarcoidosis causes in 704 patients. No single environmental or genetic trigger was identified, suggesting a complex etiology for this rare disease.
Area of Science:
- Immunology
- Environmental Health
- Genetics
Background:
- Sarcoidosis is an inflammatory disease of unknown etiology.
- Genetic susceptibility and environmental exposures are hypothesized triggers.
- The ACCESS study aimed to explore these potential causes.
Purpose of the Study:
- To generate hypotheses regarding the etiology of sarcoidosis.
- To investigate potential occupational, environmental, and infectious triggers.
- To examine genetic associations and familial aggregation.
Main Methods:
- Case-control study design with 704 newly diagnosed sarcoidosis patients and matched controls.
- Detailed questionnaires for occupational/environmental exposures.
- Molecular methods (PCR, cultures) for infectious agents.
- Genetic analysis including familial aggregation and candidate genes.
Main Results:
- No single causative agent or trigger was identified.
- The study provided a detailed clinical description of sarcoidosis at presentation.
- Complex interactions between genetic susceptibility and environmental factors are suggested.
Conclusions:
- The etiology of sarcoidosis remains multifactorial and not attributable to a single cause.
- Further research is needed to elucidate the complex interplay of genetic and environmental factors.
- The ACCESS study established a valuable dataset for future sarcoidosis research.
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